Three years ago, it seemed like I was always seeing my sports chiropractor for two recurrent injuries: a persistent tightness (and pain) in my left knee as well as my lower back. At the time, I worked out about two hours on most days, often doing long runs on the same day as intense strength training. (I knew better but couldn’t seem to stop myself.)
“Tightness in the lower back and left knee is usually indicative of adrenal fatigue,” my chiropractor told me. A marathon runner and triathlete, himself, he warned me of the perils of overtraining and recommended that I alternate cardio and weight-training and cut my workout time—by half. I blithely ignored his well-intended advice.
But, this year, I experienced a full-blown adrenal exhaustion that was impossible to ignore.
My symptoms manifested as chronic upper respiratory infections; recurrent viral infections; severe allergies; hypersensitivity to sound and smell; loss of physical stamina; flat mood; and low thyroid. In February, I knew something was inherently wrong when my biggest challenge was getting out of bed in the morning (even after eight-plus hours of sleep); then, if I managed to do so, I moved through my day as though drugged. The simple act of sitting in front of my laptop triggered anxiety and left me perspiring. Even a short telephone conversation was physically draining. Going to bed bound tighter than a mummy, in layers of long underwear and two wool sweaters for warmth—yes, I was that cold!—wasn’t fun either. And, for the first time in my life, I had absolutely zero desire to exercise.
I sought help, but conventional doctors didn’t seem to have any insight—or solutions, other than offering a prescription for an antibiotic; a steroid inhaler or oral medication for my allergies; or generic counsel along the lines of “Reduce your stress!”or “Take it easy!” before telling me to “check back in six months so we can ‘monitor’ your situation.”
I finally found an integrative doctor who asked all the right questions. He ran extensive tests, which revealed that my cortisol was very low, indicative of low adrenal function. I also had low thyroid, which frequently accompanies adrenal fatigue. By this time, my other hormones were out of whack, and he warned me that it would be at least a year before I would feel any significant improvement.
Your two grape-sized adrenal glands—each one sits on top of a kidney—produce cortisol (a.k.a. the “’fight-or-flight’ stress hormone”) and the stress neurotransmitters epinephrine (adrenaline) and norepinephrine. Cortisol raises blood sugar and increases blood pressure. It also regulates your immune system, and when your immune system is healthy, cortisol helps reduce inflammation. Depending on what stage of adrenal dysfunction you are experiencing, your cortisol levels can be either too high or too low. Chronically elevated cortisol levels suppresses the immune system, leaving you vulnerable to viruses and bacterial infections. Chronically low levels of cortisol leads to an overactive immune system, creating inflammation that may manifest as food sensitivities, autoimmune diseases (eg, Hashimoto’s thyroiditis), mood disorders and body pains and aches.
The adrenal glands also serve as a secondary source of sex hormones for both men and women.
Adrenal fatigue is all too common in our modern, multi-tasking, over-scheduled culture, where 24/7 accessibility (to products, services and people) is the norm. Yet, conventional medicine does not recognize or treat adrenal fatigue unless you have Addison’s Disease (adrenal failure or adrenal insufficiency), a rare autoimmune disease from which President John F. Kennedy suffered. Treatment protocol for Addison’s usually requires lifelong corticosteroid replacement therapy.
Adrenal fatigue can be mild (and temporary), like the college student who pulls an all-nighter. But if burning the candle at both ends becomes a perpetual way of life, cortisol levels will be continuously high. And, as we know…what goes up must come down. Eventually, as your adrenal glands falter, unable to keep up with a constant demand for cortisol, your cortisol will become persistently low. At this point, you enter a more severe and debilitating late stage of stress—adrenal exhaustion. The onset of adrenal fatigue can be gradual or triggered by a single traumatic event, such as a major surgery, toxic exposure or life crisis. Adrenal fatigue is democratic—anyone can experience it: a student, teacher, CEO, caregiver, mothers, even children.
Like a master conductor, the adrenal glands mobilize your body’s responses to stress—through hormones that maintain energy production, immune function, heart rate, muscle tone and other stress-coping mechanisms. The type of stress you experience can be emotional (eg, grieving the death of a loved one); physical (eg, over-exercising, illness, exposure to environmental toxins); or psychological (a hostile work environment, being in an abusive relationship). Caregivers are especially susceptible to adrenal fatigue. With little time to themselves and often having to divide their time between work, family, friends, spouse and care-giving, caregivers—whether caring for aging parents, someone with a disability, disease or Alzheimer’s—are at higher risk for physical health problems, as well as anxiety and depression.
Depending on your stage of adrenal fatigue (early or advanced), you can experience a collection of symptoms of varying intensity, including (but not limited to) high blood pressure, cravings for sugar or caffeine, electrolyte imbalance, light-headedness, fuzzy thinking, chronic fatigue, low blood pressure, lethargy, feeling overwhelmed, mild depression, difficulty getting out of bed in the morning, lethargy, strong cravings for salt and multiple chemical sensitivities.
In retrospect, I realize that I have had varying degrees of adrenal fatigue over the last five years. The transition to adrenal exhaustion began in early 2012—a year already fraught with professional and personal changes—when I came down with four consecutive upper respiratory infections over five months—each lingering longer than the last. Ultimately, this led to imbalances in mood and gut flora, mineral depletion, digestive distress and hormonal imbalance. At the end of last year, I was prescribed two separate courses of antibiotics, taken a month apart, further undermining my gut health and, consequently, my immune system. In my case, chronically elevated levels of cortisol resulted in my experiencing recurrent bouts of bronchitis, asthma, sinusitis or other respiratory infections. From an integrative health and functional medicine perspective, chronic infections are one of the most commonly overlooked sources of stress and resistant adrenal fatigue.
There is, however, a gift in every health challenge. My body gave me no choice but to slow the pace of my life from a sprint to a crawl—no easy task for an obsessive-compulsive Type A perfectionist (and workaholic). It’s especially challenging in New York City, where taking yourself out of the fast lane can feel like career suicide. The upside? I’ve learned life lessons that I would not have otherwise. Like, making peace with being less than “perfect”. Saying “no” becomes easier when you have little energy, as does focusing on what—and who—really matters. Most importantly, I’ve learned that recovering from adrenal fatigue is a holistic process: it takes more than an Rx for thyroid hormone or adrenal support to “snap out” of a depleted state.
Here’s the good news: with dietary and lifestyle changes, you can recover from adrenal fatigue, including later-stage adrenal exhaustion. However, self-care must be a non-negotiable priority—it’s not a sign of weakness.
In the last eight months, I’ve made progress from what felt like Ground Zero—unrelenting chronic fatigue, zero tolerance for exercise (even walking) and limited social contact—to a place where I have more energy and cautious optimism.
Stayed tuned for my next post on recovering from adrenal fatigue….I’ll be sharing my journey.
I am a runner, recently diagnosed with adrenal fatigue. I have worked hard to get to the level of running I am at and now am being told to walk only, for 6 months-2 years. I desperately want to heal and feel better, but running is my only outlet as a stay at home mom. Did you stop running? For how long? What did you do instead? How did you deal with that change?
Hi Anne,
I can appreciate the challenge you face of trying NOT to run! I don’t know your age or what stage adrenal fatigue with which you were diagnosed. If, however, you are being told to walk for 6 months to 2 years, I suspect you have an advanced stage of adrenal fatigue (Stage 3 or 4). If this is the case, I would advise you to stick to the walking protocol. Yes, I stopped doing long runs and switched to easy walking (not power walking). I’ve been a runner since age 13, and, for me, this was an incredibly difficult transition to make…but absolutely necessary. Having late-stage adrenal fatigue means that your body is running on very low energy reserves and in a state of chronic fatigue; the body perceives any kind of high-intensity exercise, like running, as a stressor that can trigger adrenal crashes. Also, running—when you have advanced adrenal fatigue—can cause (or exacerbate) electrolyte imbalances and manifest as heart palpitations, night sweats, etc. Stick with walking for now.
Kathryn,
If read dozens of explanations about adrenal fatigue but none better than yours. I specifically appreciate your advice because I too am a life long runner. Coming to grips with not being able to run has been difficult to say the least. My identity was built around running. There were several factors that caused my adrenal fatigue/ exhaustion and it took a long time to figure them out. I had extreme exhaustion in the end and have only recently come out of it (March of 2015) but still have a long way to go. I wanted to ask you if you have ever been able to run near the level you were before your adrenal fatigue set in? I was doing 2 marathons a year the 4 years leading up to.my crisis and kept my base mileage around 45/50 miles a week. I’m 49 years old now and don’t want to run that heavy mileage again but I’d like to be able to feel strong enough to consistently run 20/30 miles a week. Do you think that is possible? I came off 6 months of cortisol replacement therapy last March and have slowly worked back from walking only to now running 15 miles a week (2-4 mile runs) but I still feel a bit of that unusual fatigue at times after my runs . Do you have any advice for a runner 🙂 ? If I was content with just staying in decent shape it probably wouldn’t be an issue . Did you fully recover with time? Thanks for any advice you can give.
Hi Michael,
Thanks for reaching out. As mentioned in my post, as someone who has been running since age 13, running—and being a runner—has been a constant in my life. It’s what I did—and how I defined myself.
It sounds like you’ve been on quite a rollercoaster journey with your adrenals. If you still have a “long way to go” re: your adrenal health, then you need to listen to your body, which, by all accounts, is telling you that it needs rest—and lots of it. If you don’t take that rest—you will break your body down, bit by bit. I can tell you this from personal experience. It happened to me…adrenal fatigue kicked in when I looked my fittest a few years back—I had shredded abs, I was very lean, muscular and toned. At 5-2’1/2”, I was 97 pounds with minimal body fat (around 11 to 12%), not necessarily a good thing for a woman, as my body was breaking down internally. I suffered from electrolyte imbalance issues that manifested as muscle twitching, and I experienced some balance issues. I was frequently sick, especially susceptible to upper respiratory infections, including bronchitis, sinus infections, allergies, etc. My Stage 3 adrenal fatigue left me unable to fully function for almost a year. Only at that point—when I had little energy to move—did I finally listen to my body. No, I do not run anywhere near where I once did. Nor do I have the desire / drive to do so.
It sounds like you are trying to will your body to do more than it is physically able. Running 20-30 miles a week? Anything is possible. But, in your own words, you tell me “I still feel a bit of that unusual fatigue at times after my runs.” Your body is communicating with you. Listen. Given your running history, I’d say that you’re long overdue for a rest. Take it. And don’t feel guilty or that you’re somehow “lesser” for doing so. Adrenal fatigue is the tip of a hormonal imbalance iceberg.
It’s difficult for me to give you more specific advice without knowing more about your health history. If you’d like to schedule a 30-minute consultation with me, please email me at kathryn@kathryn-matthews.com or call 646-470-1797.
In the meantime, be good to yourself. And get off the chronic cardio treadmill.